Referral

Musculoskeletal

Musculoskeletal problems are referred to the service by a GP or consultant.

Referrals for service users being seen in a physiotherapy department (Bromyard. Ledbury, Kington, Leominster, Ross) will be screened by a senior physiotherapist and classed as either urgent or routine. Service users are telephoned to make an appointment if urgent. If the referral is routine they will be sent a letter asking them to telephone the relevant physiotherapy department to make a convenient appointment.

Urgent referrals should be assessed within 14 working days. Routine referrals should be assessed within six weeks.

In both cases service users are assessed and treatment aims and a plan are decided and delivered. 

If the problem persists they might be referred back to their GP.

Inpatients

The inpatient Physiotherapy services covers: Acute medicine, including frailty and acute admissions, Critical care, including ITU and surgery, inpatient Paediatrics, Trauma and Orthopaedics, and Women’s Health and Maternity services. Our trauma and Orthopaedic service runs 7 days a week, and our acute respiratory service runs 24hours a day, 7 days a week.

Patients who require assessment are highlighted by nursing and medical staff daily and are then screened by the ward therapists. Those who require ongoing therapy intervention are seen until they are well enough to be discharged home. If further rehabilitation is indicated there are community therapy services available in patient’s homes.  If patients are not deemed safe to return straight home then they can receive further slow stream rehabilitation within a community inpatient settings.

Neighbourhood team physiotherapy

There are community based physiotherapists working in neighbourhood teams throughout the county. They work with Occupational Therapists, Therapy Support Workers, District Nurses and Community Matrons to provide a service to housebound patients. The neighbourhood team therapists aim to provide rehabilitation to improve mobility, function and independence.

Referrals are received in to a central point and are triaged and allocated to a therapists caseload. An appointment is then booked and patients are notified by telephone of their appointment. Referrals are accepted from all referrers, i.e. self-referrals, family/carers, GP, district nurses, palliative care nurses, social workers, and hospital based staff.

The physiotherapist will assess the patient’s needs and discuss their goals and set up and deliver a treatment plan. The treatment plan will continue until the goals are met or until treatment is no longer indicated. On discharge, the physiotherapist will send a brief summary to the patient’s GP.

The waiting time to see a neighbourhood team physiotherapist varies, but a patient can expect to hear from a physiotherapist between four tor six weeks after the referral has been received. 

Hospital at home therapy

The hospital at home therapy team is a team of Physiotherapists, Occupational Therapists and Therapy Assistant Practitioners. The team work across the county to provide rapid therapy intervention to contribute in admission avoidance and to support early discharges from hospital. Urgent referrals are largely received via telephone and are taken by Senior Administrators. Referrals are accepted from all referrers, i.e. self-referrals, family/carers, GP, district nurses, palliative care nurses, social workers, hospital based staff etc.

The referral is allocated to a therapist who completes a telephone triage to ascertain the area of urgency. A visit is then carried out, on the same day if required. The team address the urgent needs and then refer the patient on to other community teams for further rehabilitation.

Hospital at home therapists respond to referrals within 24 to 48 hours and are only involved to address the urgent issues and then signpost on to other teams.

Podiatric Surgery / Physiotherapy Clinic

Service users are referred to the clinic by the podiatric surgeon.

They receive a course of treatment and are then discharged

Amputee Clinic

Service users are referred to the clinic post surgery. They are seen over a period of weeks or months to received rehabilitation and prosthetics.

Palliative Care Physiotherapy

This area of physiotherapy aims to provide assessment and treatment for patients with advanced, progressive, incurable illnesses.

The palliative care physiotherapy team based at St Michael’s Hospice offer -

· Input for inpatients staying at St Michael’s Hospice,

· Input for patients attending Day Hospice services,

· Specialist outpatient treatment in our gym,

· Fatigue and Breathlessness Groups

The palliative care physiotherapy team work as part of the specialist palliative care service, closely in conjunction with clinical nurse specialists and palliative care medical team.

The aims of this service are to help the patient improve or maintain their physical functioning, independence and gain relief from distressing symptoms. The overall aim is to improve someone’s quality of life and support them to remain in their preferred place of care.

The team accepts referrals from:

· General Practitioners;

· Consultants;

· Other health care professionals;